Official Federal Forms > US Citizenship And Immigration Services
Application For Naturalization N-400 - Official Federal Forms
| Application For Naturalization Form. This is a national form and can be used in US Citizenship And Immigration Services . |
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OMB No. 1615-0052; Expires 03/31/2013 Department of Homeland Security U.S Citizenship and Immigration Services N-400 Application for Naturalization Print clearly or type your answers using CAPITAL letters. Failure to print clearly may delay your application. Use black ink. Part 1. Your Name (Person applying for naturalization) A. Your current legal name. Family Name (Last Name) Write your USCIS A-Number here: A For USCIS Use Only Bar Code Date Stamp Given Name (First Name) Full Middle Name (If applicable) B. Your name exactly as it appears on your Permanent Resident Card. Family Name (Last Name) Remarks Given Name (First Name) Full Middle Name (If applicable) C. If you have ever used other names, provide them below. Family Name (Last Name) Given Name (First Name) Middle Name D. Name change (optional) Read the Instructions before you decide whether to change your name. 1. Would you like to legally change your name? Yes No Action Block 2. If ''Yes," print the new name you would like to use. Do not use initials or abbreviations when writing your new name. Family Name (Last Name) Given Name (First Name) Full Middle Name Part 2. Information About Your Eligibility (Check only one) I am at least 18 years old AND A. B. I have been a lawful permanent resident of the United States for at least five years. I have been a lawful permanent resident of the United States for at least three years, and I have been married to and living with the same U.S. citizen for the last three years, and my spouse has been a U.S. citizen for the last three years. I am applying on the basis of qualifying military service. Other (Explain) C. D. Form N-400 (Rev. 03/22/12) Y American LegalNet, Inc. www.FormsWorkFlow.com Part 3. Information About You A. U.S. Social Security Number B. Date of Birth (mm/dd/yyyy) Write your USCIS A-Number here: A C. Date You Became a Permanent Resident (mm/dd/yyyy) D. Country of Birth E. Country of Nationality F. Are either of your parents U.S. citizens? (If yes, see instructions) G. What is your current marital status? Marriage Annulled or Other (Explain) Single, Never Married Yes Married No Divorced Widowed H. Are you requesting a waiver of the English and/or U.S. History and Government requirements based on a disability or impairment and attaching Form N-648 with your application? I. Are you requesting an accommodation to the naturalization process because of a disability or impairment? (See instructions for some examples of accommodations.) If you answered ''Yes," check the box below that applies: Yes No Yes No I am deaf or hearing impaired and need a sign language interpreter who uses the following language: I use a wheelchair. I am blind or sight impaired. I will need another type of accommodation. Explain: Part 4. Addresses and Telephone Numbers A. Home Address - Street Number and Name (Do not write a P.O. Box in this space.) Apartment Number City County State ZIP Code Country B. Care of Mailing Address - Street Number and Name (If different from home address) Apartment Number City State ZIP Code Country C. Daytime Phone Number (If any) ( ) Evening Phone Number (If any) ( ) E-Mail Address (If any) Form N-400 (Rev. 03/22/12) Y Page 2 American LegalNet, Inc. www.FormsWorkFlow.com Part 5. Information for Criminal Records Search Write your USCIS A-Number here: A NOTE: The categories below are those required by the FBI. See instructions for more information. A. Gender Male Female B. Height Feet Inches C. Weight Pounds D. Are you Hispanic or Latino? E. Race (Select one or more) White F. Hair color Black G. Eye color Brown Blue Green Brown Blonde Asian Yes No Black or African American Gray American Indian or Alaskan Native Native Hawaiian or Other Pacific Islander Bald (No Hair) White Red Sandy Hazel Gray Black Pink Maroon Other Part 6. Information About Your Residence and Employment A. Where have you lived during the last five years? Begin with where you live now and then list every place you lived for the last five years. If you need more space, use a separate sheet of paper. Street Number and Name, Apartment Number, City, State, Zip Code, and Country Current Home Address - Same as Part 4.A Dates (mm/dd/yyyy) From To Present B. Where have you worked (or, if you were a student, what schools did you attend) during the last five years? Include military service. Begin with your current or latest employer and then list every place you have worked or studied for the last five years. If you need more space, use a separate sheet of paper. Employer or School Name Employer or School Address (Street, City, and State) Dates (mm/dd/yyyy) From To Your Occupation Form N-400 (Rev. 03/22/12) Y Page 3 American LegalNet, Inc. www.FormsWorkFlow.com Part 7. Time Outside the United States (Including Trips to Canada, Mexico and the Caribbean Islands) Write your USCIS A-Number here: A days trips A. How many total days did you spend outside of the United States during the past five years? B. How many trips of 24 hours or more have you taken outside of the United States during the past five years? C. List below all the trips of 24 hours or more that you have taken outside of the United States since becoming a lawful permanent resident. Begin with your most recent trip. If you need more space, use a separate sheet of paper. Date You Left the United States (mm/dd/yyyy) Date You Returned to the United States (mm/dd/yyyy) Did Trip Last Six Months or More? Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No No No No No Countries to Which You Traveled Total Days Out of the United States Part 8. Information About Your Marital History A. How many times have you been married (including annulled marriages)? B. If you are now married, give the following information about your spouse: 1. Spouse's Family Name (Last Name) Given Name (First Name) Full Middle Name (If applicable) If you have never been married, go to Part 9. 2. Date of Birth (mm/dd/yyyy) 3. Date of Marriage (mm/dd/yyyy) 4. Spouse's U.S. Social Security # 5. Home Address - Street Number and Name Apartment Number City State Zip Code Form N-400 (Rev. 03/22/12) Y Page 4 American LegalNet, Inc. www.FormsWorkFlow.com Part 8. Information About Your Marital History (Continued) C. Is your spouse a U.S. citizen? Yes No Write your USCIS A-Number here: A D. If your spouse is a U.S. citizen, give the following information: 1. When did your spouse become a U.S. citizen? If ''Other,'' give the following information: 2. Date your spouse became a U.S. citizen 3.
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